Colson: The Affordable Care Act works, and that’s what’s riled the GOP

John Colson
Hit & Run

Through the recent presidential election campaign and its surprising outcome — the election of Donald John Trump — we have been treated to a rather bizarre set of claims, half-truths and outright lies concerning the viability of what arguably is President Barack Obama’s single most important accomplishment, the Patient Protection and Affordable Care Act, known as the ACA or by its more derisive nickname, Obamacare.

And now the party of Trump (meaning the GOP, despite some internal disputes about Trump’s ideas and proposals) is getting ready to dismantle that program, much to the dismay of what I believe to be a majority of the country.

I’ve been reading and listening as politicians try to justify their white-hot antagonism to the ACA, and mostly it is based on a deliberately disingenuous assessment of the health-insurance program’s flaws and failures.

The claim underlying the Republican bid to dump the ACA supposedly is centered on an assumption that the ACA has not worked, has not delivered anything that it promised, and is somehow harming the country.

In fact, the ACA has given health-insurance coverage to more than 20 million Americans who could not or did not have it before, has lowered health care costs in a wide variety of ways and has overturned some of the most egregious examples of the health-insurance industry’s self-serving policies, most notably the refusal to insure people with pre-existing conditions.

I recently read an opinion piece in which the author, a woman, recalled the days before the ACA when, for some insurance scenarios, “being a woman meant you have a pre-existing condition because you might get pregnant” and thus are barred from certain kinds of affordable insurance coverage.

There were many nightmare aspects to our health care system prior to the ACA’s passage — horrible policies put in place to guarantee the insurance- and medical-industry profits but ignoring the needs of those seeking insurance — but that one, right there, really says it all.

In any event, back to the claims that the ACA never worked and thus must be dismantled.


That’s not the real reason Republicans want to get rid of it. The real reason is that it worked, kind of, and the Republican party simply cannot allow that to go unanswered, largely due to a horrific blend of partisanship, class allegiance, racism and dedication to the idea that corporate America knows best.

There are two main reasons why the ACA did not work as well as it might have.

One is the plain fact that members of Congress have a subsidized, Cadillac health care plan paid for by us, the taxpayers, and so they have no idea what it’s like to be at the beck and call of the insurance industry.

Another is that the Republican members of Congress and their surrogates in some states did everything they could to block it, undermine it and guarantee it would not work.

Take our own state’s experience.

We once had something called the Colorado Health-Op, a kind of cooperative insurance scheme that took root here and in a couple dozen other states and that, in Colorado, insured more than 80,000 people, or roughly a quarter of the Coloradans who signed up with the ACA.

The Colorado Health-Op, along with those in seven other states, essentially was shuttered at the end of 2015 after the states concluded that Colorado and other co-ops could not meet their financial obligations.

What the states, not to mention the ACA’s loud and virulent Republican critics, failed to note was that Congress, in a little-known legislative card trick that year, passed a requirement that made it inevitable that the co-ops would fail, by undermining a program known as “risk corridor” payments that were part of the ACA’s original regulations.

Under those regulations, the federal government was on the hook for subsidies to help co-ops overcome initial fiscal hurdles connected with the business. At Colorado Health-Op, officials said the insurer would be financially solvent and healthy by 2016.

But Republicans, knowing full well what they were doing, passed a rule that undercut that federal subsidy and virtually ensured that the co-ops would start failing all over the country, putting at risk the insurance policies of tens of thousands if not millions of customers.

This year, as the cascade of Republican-engineered ACA troubles rolled over the land, insurance giants such as Aetna pulled out of Colorado’s health-insurance marketplace and others, further endangering the insurance status of untold numbers of customers and patients.

And now, the critics of the ACA, having done everything they could to make sure the program would fail, are decrying its very existence and claiming they will make everything better by dismantling the ACA.

There is no plan for replacing it, of course, which most likely means our health care system once again will be run by the insurance industry in collusion with the medico-industrial complex.

Which will put us exactly where we were before the ACA was created — insurance companies will have us by the neck, premiums will reflect the industry’s need for revenue more than the customers’ needs for insurance, health care costs will again head for the stratosphere where they had been falling slightly thanks to the ACA and insurance companies will once again look for ways to cheat their customer base by refusing to cover pre-existing conditions, among other anti-people provisions.

It must be said that I was not a fan of the ACA when it was birthed — preferring a “single-payer” health care system as I do — but it was at least a start in the direction of actually providing health care at reasonable costs to all of us. As a compromise program worked out between the White House and congressional Republicans, it never could do all it was supposed to, but still, it worked better than what we had before.

Once the Republican party kills the ACA, we will see how many of us die as a result of not having insurance to meet the ridiculously high costs charged by doctors and hospitals.

I can only hope that, come election time in 2018 and beyond, we know the truth of this tale, and will remember it.

Email at